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Individual

MS. AZUCENA MIRANDA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
15339 SATICOY ST, VAN NUYS, CA 91406-3345
(818) 267-2681
Mailing address
15339 SATICOY ST, VAN NUYS, CA 91406-3345
(818) 267-2681

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
225400000X
Rehabilitation Practitioner

Other

Enumeration date
04/09/2020
Last updated
06/10/2020
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